1. Doctors Opposing Circumcision: An Appeal for Misha

Comment #32828 by pugowner on April 18, 2007 at 11:36 am

As Krogercomplete notes, case law on "mature minors" does not extend to all situations in all states, especially to a 12 year old refusing to consent to a treatment or procedure.

I have extracted excerpts from the American Academy of Pediatrics guidelines. These guidelines do not have the force of law. They only serve to illustrate the principles that all parties would have to deny for this case to evolve as reported:

We realize that the doctrine of "informed consent" has only limited direct application in pediatrics. Only patients who have appropriate decisional capacity and legal empowerment can give their informed consent to medical care. In all other situations, parents or other surrogates provide informed permission for diagnosis and treatment of children with the assent of the child whenever appropriate.

In attempting to adapt the concept of informed consent to pediatrics, many believe that the child's parents or guardians have the authority or "right" to give consent by proxy. However, the concept encompasses many ambiguities, thus "proxy consent" poses serious problems for pediatric health care providers. Such providers have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses. Although impasses regarding the interests of minors and the expressed wishes of their parents or guardians are rare, the pediatrician's responsibilities to his or her patient exist independent of parental desires or proxy consent.

Pediatricians should not necessarily treat children as rational, autonomous decision makers, but they should give serious consideration to each patient's developing capacities for participating in decision-making, including rationality and autonomy. As minors mature, their interest in and capacity for participating in health care decisions affecting themselves increases, as does their ability to make decisions regarding their parents' religious views.

There are clinical situations in which a persistent refusal to assent (ie, dissent) may be ethically binding. This seems most obvious in the context of research (particularly that which has no potential to directly benefit the patient). A patient's reluctance or refusal to assent should also carry considerable weight when the proposed intervention is not essential to his or her welfare and/or can be deferred without substantial risk.

2. Doctors Opposing Circumcision: An Appeal for Misha

Comment #32809 by pugowner on April 18, 2007 at 9:56 am

Michaelangelo,

Hopefully you were just making a rhetorical point, but in case you were serious:

The term "Torah" in Judaism can be given either of two meanings. When one refers to reading the Torah, this is the Tanach - the first five books (Genesis, Exodus, Leviticus, Numbers, Deuteronomy) one sees as a scroll and read in weekly portions throughout the year.

"Torah" can also refer to all of the holy writings as an inclusive concept. However, nowhere in the spectrum of Jewish practice is one expected or encouraged to read all of these writings because they don't have equal value or importance. The prophets such as Jeremiah have a minor role (if any) in Jewish philosophy and practice, and elicit little attention except for selected readings and excerpts.

3. Medicine without Evolution Make Sense?

Comment #32779 by pugowner on April 18, 2007 at 8:46 am

I find it disingenuous to use the example of bacteria developing antibiotic resistance in arguments about evolution. Opponents have no difficulty with change based on mutation and natural selection when it comes to evolution within a species - be it bacteria, plants or dogs.

The larger arguments are at least two-fold. One is direct: understanding the mechanisms of biology provide benefits in the application of current knowledge and the development of new insights. The second is indirect: scientists (and physicians are trained in science) who reject science on principle become oxymorons. Sorry about that typographical error - drop the "oxy".

4. Doctors Opposing Circumcision: An Appeal for Misha

Comment #32773 by pugowner on April 18, 2007 at 8:24 am

Unfortunately, my previous efforts to post were lost and I hadn't saved the text before submission. There are several reasons to be skeptical about the original message, and I'm sorry to see Richard Dawkins has personally made public references to it.

Custody battles are often presented in a distorted light, not least when one of the parties is an attorney, and I am not confident of trusting the claims of this advocacy organization. The case as presented is contrary to established principle in all three relevant areas: medical ethics, Jewish ethics, and case law.

Medical ethics and case law: There is an established principle of the mature minor - a child under the age of majority who is capable of a rational and informed decision. Problematic cases entail a mature minor's decision to forgo a life-saving procedure such as chemotherapy or a blood transfusion. A physician over-riding a 12 year old's objection to an elective circumcision would be acting contrary to established written guidelines from every revelant medical organization in the U.S. He or she would risk both licensure censure from the state Board of Medicine and have no professional support during a civil lawsuit for battery. Civil action in most, if not all states, can be filed by the child up until two years after the child attains the age of majority.

Judaism: (1) does not encourage conversions, and (2) goes to great lengths to ensure that the person is converting out of a sincere and voluntary motivation. Since a male becomes an adult in religious observance at age 13, with a prolonged period of pre-adult responsibilities in preparation for this event, the concept of a mature minor is applicable to a 12 year old boy. I can't quote halacha (Jewish law), but I am confident of the principle across the spectrum of Jewish observance. Also, abhorence of the forced conversion of Jewish children to Catholicism, cited in TGD, is a subject that is not taken lightly and applies in reverse.

Of course individuals can flount established principles and case law. A doctor can be ignorant of medical ethics and unknowingly risk his license and financial worth, a rabbi can act contrary to Jewish ethics, and a family court judge can ignore precedents with the approval of an appeals panel. All I am stating that a little skepticism is in order before one commits money or reputation to this case.

5. Yanoconodon, a transitional fossil

Comment #26228 by pugowner on March 17, 2007 at 9:14 pm

MelM: I wonder if the American Psychological Association would pass a resolution to state that while the APA opposes discrimination against the GLBT community, this is not meant to question the legitimacy of declaring homosexuality an abomination as a religious philosophy.

6. God, sex, drugs and politics

Comment #22580 by pugowner on February 19, 2007 at 4:48 pm

While there are reasonable issues about the HPV vaccine, the logic of mandating the vaccine is straightforward. The vaccine is most effective when given before the onset of sexual activity. Voluntary immunization with the Hepatitis B vaccine, also indicated before sexual activity, failed to cover more than 15% of the population at risk in the United States, while mandated vaccination increased the rate to around 90%.

7. How Old is the Grand Canyon? Park Service Won't Say

Comment #15302 by pugowner on December 30, 2006 at 8:51 am

My experience visiting U.S. national parks is that scientifically accurate information is presented. I routinely ask park rangers and staff about challenges from Bible literalists. They tell me it is an infrequent problem, and they don't change their presentation to avoid potential objections.

I invite you to check the official NPS website for the Grand Canyon: http://www.nps.gov/grca. I did not find any allusions or links to anything unscientific. To quote the website:

Well known for its geologic significance, the Grand Canyon is one of the most studied geologic landscapes in the world. It offers an excellent record of three of the four eras of geological time, a rich and diverse fossil record, a vast array of geologic features and rock types, and numerous caves containing extensive and significant geological, paleontological, archeological and biological resources. It is considered one of the finest examples of arid-land erosion in the world.

How old is the Canyon?

That's a tricky question. Although rocks exposed in the walls of the canyon are geologically quite old, the Canyon itself is a fairly young feature. The oldest rocks at the canyon bottom are close to 2000 million years old. The Canyon itself - an erosional feature - has formed only in the past five or six million years. Geologically speaking, Grand Canyon is very young.

Are the oldest rocks in the world exposed at Grand Canyon?

No. Although the oldest rocks at Grand Canyon (2000 million years old) are fairly old by any standard, the oldest rocks in the world are closer to 4000 million years old. The oldest exposed rocks in North America, which are among the oldest rocks in the world, are in northern Canada.